HomeMy WebLinkAboutMortgage_Coomer s'w=-''`a� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
a7 �`1 FOR DEDUCTION FROM ASSESSED VALUATION
tlr� ' Gibson 0 2.. 2020
,i. r State Form 43709(R14/1-20)
mils Prescribed by Department of Local Government Finance
7
'AN 0.4 2021 File Mark
INSTRUCTIONS: To be filed in person or by mail. _5L Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. [J County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property
is located on or before January 5 of the calendar year in which the property taxes are first due and payable. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Ryan Coomer
Taxing District Key number/legal description Record number PR,ge number
Oen 26-11-31-300-004.237-021 /LAKEVIEW ESTATES 6 94 {p Q 4G
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Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
$218,000.00 Ids ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is thepperty in question:Annually Assessed
lsd'Real Property ❑ Annually Assessed
• Mobile Home(IC 6-1.1-7)
Name of mortgagee contract FILED
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
4401 Theater Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage JAN 01204
Address of assignee(number and street,city,state,and ZIP code)
. Ji'r": P
frnca
GIBSiON COUNT t l
Does applicant own property in If yes,what county? What Taxing District? Has this deduc on to-• cI If yes,state amount of deduction
other county El Yes No on property for on Yes El No
in Indiana? current year.
A person is not entitled to this deduction unless the person has'a balance on the person's mortgage or contract indebtedness that is recorded in the county
recorder's office(including any home equity line of credit that is recorded in the county recorder's office)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 fjvit20 20 20 20 20 20
Signature of County A f County Date onth,d ,year)_
Gibson OE Q �l
I,We certify under penalty of perjury that e above and foregoing information is true and correct and that the applicant is a resi ent of I diana an
owner/contract buyer of the aforementioned property on date application is filed.
Sig a ner's full na t pate month,day,year)
Full resi nt address of applicant(number and street,city,state,and ZIP code)
6136 W.Stalheim Ave., Owensville, IN 47665
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 ' Date(month,day,year)
Address of authorized person(number and street,city,state,and ZIP. code)
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